Mr. LASKER. I have made contributions to committees that were ubject to the deduction privilege, Senator Murray, or which I thought vere. I'd hate to be prosecuted.

Senator MURRAY. I don't mean to prosecute the individuals who make the contributions, but I think those who induced them to do it, who asked them to violate the law, should be prosecuted. They have sed that deduction privilege illegally.

Mr. LASKER. Well, don't they have a tax-exemption certificate from he Treasury.

Senator MURRAY. No; they do not.

Mr. LASKER. Oh, I misunderstood. I withdraw the whole thing. Then it is a matter between those who have made the deductions and he Treasury.

Senator MURRAY. Now, you say that you would like to see a broad liscussion of this subject in the public press?

Mr. LASKER. Yes.

Senator MURRAY. And you do not approve of the conduct of some who accuse us who sponsor this legislation of being in some manner connected up with Communists and Socialists?

Mr. LASKER. Senator, let me tell you a little story that will give you in illustration of my feeling on that phase of it. I once was playing bridge with a man, and I happened to make a bid that he didn't like. He was my partner at the time. He turned to me, and with great disgust, he said "Fascist."

I am unimpressed by sloganizing. The word "socialistic" can be given to S. 545, and in principle I am for everything, almost everything, that is in S. 545, so then to that extent I am for socialistic medicine. I merely say that there are some areas in which every society has to go socialistic. One is veterans' medicine, another is for the indigent. But I am in favor of having medicine and medical treatment made available to the two-thirds of the producing people who cannot afford it now.

Senator DONNELL. Any questions?

Senator PEPPER. No questions.

Senator MURRAY. No further questions.

Senator DONNELL. We are very appreciative of your attendance here today and your testimony. We hope you will be able to catch your train.

Senator MURRAY. Mr. Chairman.

Senator DONNELL. Yes.

Senator MURRAY. On behalf of the other Senators who have been associated with us on this bill I want to present some statements from them to be put in the record, and also the report that Senator Pepper and I put in last year, as a statement from us.

Senator DONNELL. I understand the statements are from Senator Wagner, of New York; Senator McGrath, of Rhode Island; Senator Taylor, of Idaho; Senator Chavez, of New Mexico; Senator Murray, of Montana; and Senator Pepper, of Florida.

Senator MURRAY. That is correct.

64431-48-pt. 3- -24

Senator DONNELL. They will be incorporated into the record, an I shall also offer, with your approval, for the record, a release by th Committee for the Nation's Health, Inc., for release Thursday, Jul 10, 1947, referring to the charges made by Mr. Thurman Arnol being an exhibit to which I referred earlier in the testimony toda Senator PEPPER. No objection.

Senator MURRAY. No objection.

(The document referred to follows:)

[For release Thursday, July 10, 1947]

THURMAN ARNOLD CHARGES AMA WITH MONOPOLISTIC PRACTICES

COMMITTEE FOR THE NATION'S HEALTH, INC.,

Washington 1, D. C.

Charging that medical societies "have assumed power over the practice of the profession, licensed by the State, and over the civil rights of American citizens Thurman Arnold, former Assistant Attorney General, launched an attack on th Taft health bill.

Specifically referring to the health bill now sponsored by Senators Taft, Ball Smith, and Donnell, the former trust buster declared that in his opinion "th bill would substantially increase the powers and monopolistic control of organized medicine."

He charged that the Taft bill would give "substantial control over the policies for expending Federal funds to officials who would be the creatures of organiza medicine. * * He told the Committee for the Nation's Health, which is supporting the national-health insurance bill, S. 1320, that in his opinion the Taft bill would increase the "* monopolistic powers and tendencies now exercised by these State societies."

*

Arnold had been asked by the Committee for the Nation's Health for an opinion on the monopolistic implications, if any, of the Taft bill. The full text of the Arnold letter is attached.

(The Committee for the Nation's Health will testify before the Health Subcom mittee of the Senate Committee on Labor and Public Welfare on July 10. Spokes men will be Joseph Louchheim, executive director, and Dr. Michael Davis chairman of the executive committee.)

Senator MURRAY. Senator Pepper and I have stated our own posi tions on the basic principles involved in S. 545 and S. 1320 during last year's hearings on S. 1606 and during the hearings before this subcommittee. It is not necessary to repeat them at this point.

We do ask, however, that report No. 5 of the Subcommittee on Health and Education to the Committee on Education and Labor, dated July 1946, be placed in the record of these hearings along with the statements of the cosponsors of S. 1320.

Senator Pepper and I believe it to be the most complete, concise, and accurate presentation of the need for national health insurance and of the inadequacies of current attempts to solve the problem before us.

(The document referred to and the statement of Senators Wagner, McGrath, Taylor, and Chavez follow in succession :)

EPORT TO THE SENATE COMMITTEE ON EDUCATION AND LABOR FROM THE SUBCOMMITTEE ON HEALTH AND EDUCATION

We have the honor to submit herewith the fifth interim report of le Subcommittee on Health and Education.

The subcommittee's third interim report, issued in January 1945, resented a series of facts showing the gravity of the Nation's health roblem. Over 40 percent of the Nation's selectees were found unfit or military duty, and at least a sixth of these had defects which were mediable; many more had preventable defects.

In fact, more than 23,000,000 people in the country have some hronic disease or physical impairment. On any one day, at least ,000,000 people in the United States are incapacitated by sickness r other disability, half of them for 6 months or more. Illness and ccidents cause the average industrial worker to lose about 12 days rom production a year, a loss of about 600,000,000 man-days annually. ickness and accidents cost the Nation at least $8,000,000,000 a yeartalf of this amount in wage loss and half in medical costs.

Preventive services are inadequate-40 percent of our counties do ot have even a full-time local public health officer. Sanitation needs re great-846,000 rural homes do not have so much as even an outloor privy. Hospitals are needed-40 percent of our counties, with in aggregate population of 15,000,000, do not have a single recognized general hospital. Doctor shortages are severe-in 1944, 553 counties ad less than 1 active physician per 3,000 population, the "danger ine," and 81 had no active doctor at all. Even in 1940, before many doctors were drawn off to war, 309 counties had less than 1 active physician for every 3,000 people, and 37 had no active doctor at all. Maternal and child-health services are inadequate it is estimated that half the maternal and a third of the infant deaths could be prevented if known measures were fully applied. Seventy-five percent of our rural counties have no prenatal or well-baby clinics at all under the supervision of State health departments. State agencies had 15,000 children on their lists awaiting crippled children's care in early 1944. They do not even pretend to care for the half-million children with rheumatic fever (the most killing of all diseases for children between ages 5 and 15) or for the tens of thousands of cerebral palsypa("sstic paralysis") victims.

To meet such problems, the subcommittee recommended Federal action with regard to certain features of a national health program, including Federal grants for hospital and health center construction,

touched. In any year, 47 percent of the people will have no serious illness at all, 51 percent will be sick one to three times, and 2 percent four or more times. The next year, some new families will be hit, while some of the same families will continue to suffer. The costs of medical care are also subject to wide variation. In any year, a tenth of the population has to bear four-tenths of the total burden of medical expenditures (fig. 1).

When sickness does hit hard, wage losses and medical costs may wipe out a family's entire savings and drive it into debt. Material in our files indicates that people borrow from small loan companies to meet medical expenses more frequently than for any other single reason. Illness is also the most frequent cause leading people to seek

Ip through charity except in periods of widespread and long-conued unemployment.

Even on the average, medical care has become increasingly costly. he average family reported an expenditure of $100, or 4.6 percent of income, for medical care in 1944. No later national data are ailable, but a study conducted by the Bureau of Labor Statistics owed that the average medical care expenditure by urban families 1944 was $133; rural expenditures are known to be somewhat less. There is an inverse relationship between the amount of sickness and e amount of medical care received by people in various income oups in our country at the present time. People with low incomes wve more sickness and need more medical care, yet they receive less an those in the upper-income groups. (See fig. 2.)

IGURE 2. THE LOWER THE INCOME, THE MORE SICKNESS AND THE LESS CARE

Index chosen to show amount of sickness is days of disabling illness annually, representing disabilities sting 7 days or longer in age group 15 to 64. National Health Survey data. Index chosen to show medical care received is doctor calls per person, including home, office, and clinic alls or visits, health examinations (including immunizations), well-baby clinic visits, and eye refractions er person annually. Committee on the Costs of Medical Care data.

Medical care is still, in the main, received in accordance with ability to pay rather than in accordance with need. It is often argued that this is not so that no doctor will turn down a patient because he has no money, and that charity beds are available in hospitals for those who cannot afford to pay.

There is a modicum of truth in this. Most doctors spend part of their time giving care free to patients, and most hospitals have some beds for charity patients. But this tells only part of the story.

1 Spending and Saving of the Nation's Families in Wartime. U. S. Department of Labor, Bull. No. 723, October 1942, p. 20.